National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts.org
Search Results

This is VAERS ID 1777819

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 10/15/2021

VAERS ID: 1777819
VAERS Form:2
Age:74.0
Sex:Female
Location:New Jersey
Vaccinated:2021-10-09
Onset:2021-10-09
Submitted:0000-00-00
Entered:2021-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037C21A / 3 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Arthralgia, Chills, Fatigue, Hyperhidrosis, Infection, Injection site erythema, Pain, Pyrexia, Injection site swelling, Extra dose administered, Adverse reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: 3/06/21 Moderna 2nd shot
Other Medications: Dexilant 60mg,Simvastatin 40mg, Telmastartin, estrogen, progesterone,100, Welbutrin 100
Current Illness: none
Preexisting Conditions: none
Allergies: Bactrum/sulpher
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up: injection given at 9:30am 10/09/21. Adverse reaction started at 4pm same day. Chills alternating with sweats, low grade fever, extreme pain in joints and muscles all over body, extreme fatigue. Symptoms subsided next day Sunday 9pm. Symptoms returned Monday approx 10am as well as extreme swelling and redness at injection site and down my arm approx 6inches. Saw my general physician. He decided to treat as an infection. Medication prescribed:Cephalexin 500mg. At this time, only 2 doses of medication have been taken. No change yet.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1777819&WAYBACKHISTORY=ON


Copyright © 2022 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166